MARINE CORPS AIR STATION IWAKUNI, Japan --
When it comes to medical care, a patient’s doctor is one of the many people who will provide treatment during the clinical process. It could be considered impossible for a doctor to examine, diagnose, supply medication to and treat all of their patients on their own.
The ancillary department of the Robert M. Casey Medical and Dental Health Clinic, as the name suggests, provides support to the main function of the clinic, keeping Iwakuni residents healthy and mission capable.
“We fill prescriptions for any of the active duty service members here, their family, and anyone else who is eligible for care at the clinic, which includes anyone enrolled in Tricare or who has insurance registered at the clinic,” said Navy Lt. Rachel Lantieri, a pharmacist with the clinic and ancillary division officer.
Lantieri mentioned that while the clinic carries most of what United States Naval Hospital Yokosuka carries, the selection is still restricted because of limited space.
“We can always orders things, so it’s important for patients to know that it’s best to be proactive, so they can help us help them. If they come to us sooner, we can make sure to place an order for them that we may not normally carry,” said Lantieri. “Supply is our biggest challenge in pharmacy. A normal order will take a week to two, but with more specialized and controlled medications, it can be over a month. We can always get something, it’s just how long it’s going to take.”
The pharmacy operates from 8 a.m. to 4 p.m. and, similar to other ancillary services, a patient’s provider facilitates their visit.
The only other avenue a person could take to access the pharmacy would be if they had a current or an existing prescription from another military facility, in which case, pharmacist personnel transfer a person’s record into the clinic’s database.
According to Lantieri, the ancillary division has earned the title of “behind the scenes healthcare,” because almost every patient who goes through a provider ends up utilizing an ancillary service, be it lab, pharmacy or radiology.
“We see most of the patients who enter the clinic,” said Lantieri. “Whether they need something over the counter for a cough or cold, or if they need something seriously prescribed for blood pressure. Our whole mission here is to make sure we’re keeping our active duty mission capable, so they can go out and complete their missions. If we aren’t treating them with our medications and they’re not deployable, then we’re not doing our job.”
While most of the clinic’s patrons funnel through the pharmacy, it’s the laboratory service that helps providers decide on what medication their patients need.
According to Petty Officer 1st Class Erle Arnold, leading petty officer for the ancillary division of the clinic, the lab is used for diagnostic testing in order to help providers with their patients.
“Our job is to collect samples and send them out for testing. We’re also kind of in a (remote) location, so some testing that may be considered routine at regular treatment facilities, here, it’s not routine,” said Arnold. “Things such as HIV, some specialized tests for thyroid, things like that are sent to Yokosuka. We do some labs in house and those are usually done the same day.”
Arnold said that shipments to Yokosuka usually take between five to seven business days for a result to return to Iwakuni. Test samples normally ship out once monthly, unless there is no extra storage space available. If a person is tested on the first of the month, the sample may not ship until the 28th or 30th of that same month.
Arnold also mentioned that the lab won’t draw blood on children younger than five unless for a Women, Infants and Children appointment, which take place only on Wednesdays and must be set up through an individual’s provider. For other days, young children must be seen on the second floor of the clinic at family practice.
Arnold said other key things he wants Iwakuni residents to know are the lab’s hours of operation range from 8:30 a.m. to 4 p.m. and that the lab does not give out results. A patient’s provider will supply the results from lab testing to the patient.
“The lab helps the doctors. They rely on the lab to confirm or rule out symptoms and diseases,” said Arnold, “It helps them confirm their decisions. They have the knowledge and experience, the lab helps them say, ‘it’s definitely this or it’s definitely not this.’”
Arnold gave streptococcal pharyngitis, also known as strep throat, as an example, saying that you can see the symptoms of strep by looking at a person’s throat and analyzing symptoms, but to confirm it, the lab has to perform a strep test.
“If you keep coming in and saying you have a sore throat and we keep treating it as strep, but we didn’t confirm it, and we just start giving you antibiotics, that’s how super bugs are created, because (hospitals) give people antibiotics when they don’t need antibiotics,” said Arnold. “The disease-causing bacteria build a resistance to it. That’s how (Methicillin-Resistant Staphylococcus Aureus) MRSA came about, doctors were treating colds and such with antibiotics without testing it. All the other diseases build up resistances to them, so it’s very important that we properly diagnose what’s going on with a patient, so we can properly treat them for what they have. It makes no sense to give somebody the antibiotics to treat a bacterial infection when they have a viral infection.”
For illnesses that take a more physical aspect, such as injured bones or tissue, the radiology department of the clinic provides the necessary outlet to help beneficiaries when such necessities arise.
However, according to Petty Officer 3rd Class Dexter Pelonia, a corpsman and radiology technician with the clinic, the radiology department has equipment inside the clinic to support only basic diagnostic tests. While radiology personnel process magnetic resonance imaging (MRI) and X-ray commuted tomography (CT) from out in town, patients still need to go through the medevac procedure for such scans.
Pelonia mentioned the different kinds of fractures and injuries that could prove detrimental to a person’s health if it wasn’t for the ability to provide scans.
“If you have injuries to your thorax, your trunk or your skull, those are the injuries that are hard to cure if you can’t actually see what is wrong,” said Pelonia. “X-rays are just another tool to help the doctors see things that can’t normally be seen, like hairline fractures and such. That’s why they need to be able to utilize X-rays.”
“There are Marines on base who are always active and there is a possibility of them getting injured,” said Pelonia. “If they do get injured, X-rays can be the main way, sometimes, to find out what is wrong and help fix those injuries.”
This is the second story in a series about the clinic. The next story will focus on the physical therapy service provided by the clinic.